Individual provider Active NPI

Philip Steven Gura, D.C.

  • Sports Physician Chiropractor
  • East Rockaway, NY
National Provider Identifier
1104914191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
X005605-1 Issued in NY
Practice address
559 Atlantic Ave
East Rockaway, NY 11518-1530
Phone
(516) 593-8333
Fax
(516) 593-8344
NPI assigned
Oct 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X X005605-1 NY Primary

Addresses

Primary practice location

559 Atlantic Ave
East Rockaway, NY 11518-1530

Mailing address

559 Atlantic Ave
East Rockaway, NY 11518-1530
Phone (516) 593-8333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719000948 NY Practitioner - Chiropractic 2769461177 Practice locations: East Rockaway, NY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

559 Atlantic Ave
East Rockaway, NY 11518-1530
Phone (516) 593-8333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005605-1NYMDSports Physician Chiropractor
005605NYMDOptician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104914191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 ATLANTIC AVE",
            "city": "EAST ROCKAWAY",
            "state": "NY",
            "postal_code": "115181530",
            "telephone_number": "516-593-8333",
            "fax_number": "516-593-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 ATLANTIC AVE",
            "city": "EAST ROCKAWAY",
            "state": "NY",
            "postal_code": "115181530",
            "telephone_number": "516-593-8333",
            "fax_number": "516-593-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURA",
        "first_name": "PHILIP",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NY",
            "license": "X005605-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.